INTRODUCTION: Anti-amyloid antibodies for the treatment of Alzheimer´s disease (AD) are currently being evaluated for approval and reimbursement in Europe. An approval brings opportunities, but also challenges to health care systems across Europe. The objective of this position paper is to provide guidance from experts in the field in terms of navigating implementation. METHODS: Members of the European Alzheimer's Disease Consortium and a representative of Alzheimer Europe convened to formulate recommendations covering key areas related to the possible implementation of anti-amyloid antibodies in AD through online discussions and 2 rounds of online voting with an 80% threshold for a position to be accepted. RESULTS: In total, 24 recommendations were developed covering the research landscape and priorities within research in AD following a possible approval, potential impact on health care systems and diagnostic pathways, and communication to patients about anti-amyloid antibodies. Anti-amyloid antibodies are regarded as a substantial innovation with an important clinical impact. In addition, however, new compounds with other mechanisms of action and/or route of administration are also needed. Approval of new treatments will require changes to existing patient pathways and real-world data needs to be generated. CONCLUSION: Comprehensive guidance is provided on the potential implementation of anti-amyloid antibody therapies in Europe following possible approval. Emphasis is placed on the necessity of regularly updating recommendations as new evidence emerges in the coming years.

Ace Alzheimer Center Barcelona Universitat Internacional de Catalunya Barcelona Spain

Aging and Inflammation Theme Karolinska University Hospital Stockholm Sweden

Alzheimer Europe Luxembourg Luxembourg

Carol Davila University of Medicine and Pharmacy Bucharest Romania

Clinical Division of Neurogeriatrics Department of Neurology Medical University Graz Graz Austria

Danish Dementia Research Centre Department of Neurology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark

Dementia Research Centre UCL Queen Square Institute of Neurology UCL London UK

Department of Biomedical Sciences University of Antwerp Antwerp Belgium

Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark

Department of Geriatric Psychiatry Medical Faculty Mannheim Central Institute of Mental Health Heidelberg University Mannheim Germany

Department of Neurology 2nd Faculty of Medicine Memory Clinic Charles University and Motol University Hospital Prague Czech Republic

Department of Neurology Aiginition Hospital National and Kapodistrian University of Athens Medical School GR Athens Greece

Department of Neurology and Bru BRAIN NEUR Research Group Center for Neurosciences Brussels Belgium

Department of Neurology Faculty of Medicine University Medical Center University of Ljubljana Ljubljana Slovenia

Department of Neurology Taub Institute for Research in Alzheimer's Disease and the Aging Brain The Gertrude H Sergievsky Center Columbia University New York NY USA

Department of Psychiatry Medical Faculty University of Cologne Cologne Germany

Division of Clinical Geriatrics Department of Neurobiology Care Sciences and Society Karolinska Institutet Stockholm Sweden

Division of Neurogeriatrics Department of Neurobiology Care Sciences and Society Karolinska Institutet Solna Sweden

Division of Neurogeriatrics Dept of Neurobiology Care Sciences and Society Theme Inflammation and Aging Karolinska Institutet Karolinska University Hospital Huddinge Sweden

Excellence Cluster On Cellular Stress Responses in Aging Associated Diseases University of Cologne Cologne Germany

Faculty Geneva College of Longevity Science Geneva Switzerland

Faculty Geneva School of Business Administration University of Applied Sciences of Western Switzerland Geneva Switzerland

Frontlab Paris Brain Institute AP HP Pitié Salpêtrière Hospital Paris France

German Center for Neurodegenerative Diseases Bonn Germany

Institute of Memory and Alzheimer's Disease Sorbonne University Pitié Salpêtrière Hospital Paris France

LANVIE Laboratory of Neuroimaging of Aging Memory Centerand University Hospitals and University of Geneva Geneva Switzerland

Networking Research Center On Neurodegenerative Diseases Instituto de Salud Carlos 3 Madrid Spain

President Ana ASLAN International Foundation Excellence Memory Center Brain Health and Longevity Medicine Bucharest Romania

Toulouse Clinical Research Center Toulouse University Hospital Toulouse France

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